Provider Demographics
NPI:1952469124
Name:PODD, DANIEL (RPA-C)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:PODD
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 BAY PKWY
Mailing Address - Street 2:SUITE 901
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-6079
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6010 BAY PKWY
Practice Address - Street 2:SUITE 901
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6079
Practice Address - Country:US
Practice Address - Phone:718-238-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10924363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical